The Development of Alcohol Use and Abuse in ADHD Adolescents and Young Adults

描述（由申请人提供）：此竞争性续期申请要求提供11-15年的资金，以继续研究匹兹堡ADHD纵向研究（帕尔斯）中酒精使用和酒精使用障碍的发病、病程、原因和后果。在帕尔斯中，364名ADHD儿童（先证者）在参加匹兹堡大学WPIC的ADHD夏季治疗计划后的小学年龄段被确定。这是同类研究中规模最大的一项：严格诊断儿童多动症，详细全面的儿童数据（包括标准化和客观数据），以及理论上与酒精滥用和酒精依赖发展相关的领域的详细年度随访评估（例如，酒精中毒家族史;酒精预期）。一个非ADHD人口统计学上相似的参与者组（n=240）在第一次随访期间的先证者之间的补助金年1和5时，参与者年龄范围从11至25。采用队列序贯设计，自招募至帕尔斯以来，每年对所有受试者进行随访;保留率超过90%，并且始终采用多报告者方法。结果表明：1）先证者青少年酗酒和AUD风险较高; 2）当对照组也酗酒时，18-25岁的AUD无先证者-对照组差异; 3）终生兴奋剂治疗持续时间与成年早期酗酒之间存在正相关，4）儿童期行为问题与后来的饮酒结果之间存在弱相关，但同时存在强相关，支持多动症吗行为？AUD通路，以及5）父母监控对青少年饮酒频率纵向增长的ADHD风险的调节作用。要求持续随访（每年一次至25岁，此后定期进行针对年龄的评估），以确定早期重度饮酒模式是否持续到20多岁（停止饮酒是美国的常态），以确定新的AUD病例是否在20多岁中后期发展，并研究这些AUD发展和成年早期后果的假定因果机制。公共卫生相关性：这是一项关于儿童时期被诊断为注意力缺陷多动障碍（ADHD）的酗酒者的大型长期研究。这项研究将有助于解释为什么ADHD儿童有酗酒的风险，包括哪些因素导致风险，哪些因素降低风险。ADHD是美国儿童最常被诊断出的心理健康问题之一;这些人的酗酒风险给社会带来了巨大的直接和间接成本。这项研究将提供信息，以改善预防以及治疗酒精问题，在这一大组的高风险儿童在美国。

DESCRIPTION (provided by applicant): This competing renewal application requests funding for Years 11-15 to continue study of the onset, course, causes, and consequences of alcohol use and alcohol use disorders in The Pittsburgh ADHD Longitudinal Study (PALS). In the PALS, 364 children with ADHD (probands) were ascertained in their elementary school-aged years following their participation in the ADHD Summer Treatment Program at WPIC, University of Pittsburgh. This is the largest study of its kind: rigorously diagnosed ADHD in childhood, detailed comprehensive childhood data (including standardized and objective data), and detailed annual follow-up assessments of domains theoretically related to the development of alcohol abuse and alcohol dependence (e.g., family history of alcoholism; alcohol expectancies). A nonADHD demographically similar group of participants (n=240) was recruited during the first follow-up of the probands between grant years 1 and 5 when participant ages ranged from 11 to 25. Using a cohort sequential design, all participants have been followed annually since recruitment into the PALS; retention is over 90% and a multiple reporter approach has been adopted throughout. A sampling of findings includes: 1) a higher risk for heavy drinking and AUD in proband adolescents; 2) absence of proband-control differences for AUD at 18-25 yrs when controls are also drinking heavily; 3) positive association between duration of lifetime stimulant treatment and early adulthood binge drinking, 4) weak associations between childhood conduct problems and later drinking outcomes but strong concurrent associations, supporting an ADHD?conduct?AUD pathway, and 5) moderating influence of parental monitoring on ADHD risk for longitudinal growth in adolescent drinking frequency. Continued follow-up (annual to age 25, age-targeted periodic assessments thereafter) is requested to determine whether early heavy drinking patterns persist through the twenties when desistance is the U.S. norm, to determine whether new cases of AUD develop in the mid-to-late 20s, and to study the putative causal mechanisms underlying these AUD developments and consequences in early adulthood. PUBLIC HEALTH RELEVANCE: This is a large long-term study of alcoholism in people who were diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) in childhood. This study will help explain why children with ADHD are at risk of alcoholism, including what factors contribute to the risk and what factors decrease the risk. ADHD is one of the most frequently diagnosed mental health problems of children in the United States; alcoholism risk in these individuals carries large direct and indirect costs to society. This study will provide information to improve prevention as well as treatments for alcohol problems in this large group of high risk children in the U.S.